Assessment of the prognostic value of certain acute-phase proteins and procalcitonin in the prognosis of acute pancreatitis.
OBJECTIVE
Of patients with acute pancreatitis (AP), 20% develop severe attacks that need early and intensive therapy. Yet, to administer such treatment, it is important to classify early on the patients with mild and severe pancreatitis. The aim of this study was to evaluate the role of serum amyloid A, C-reactive protein, procalcitonin, and routinely measured parameters in the early prediction of the course of AP.


METHODS
A total of 40 consecutive patients with AP confirmed by computed tomography were prospectively enrolled in the study-29 were graded as mild and 11 were graded as severe. Blood samples were obtained on admission and 24 hours thereafter.


RESULTS
Procalcitonin concentration in both measurements was significantly higher in patients with severe pancreatitis, and the cutoff level was estimated at 0.5 ng/mL. Although serum amyloid A and C-reactive protein levels rose significantly during the period of observation, these were not differentiated between both groups. Among the routinely measured parameters, a prognostic value was found for total calcium concentration, lactic dehydrogenase activity, and glucose concentration.


CONCLUSIONS
The best efficiency in the early prediction of severe AP would be achieved with the measurement of procalcitonin, total calcium level, and lactic acid dehydrogenase activity immediately after admission to the ward.
Gurda-Duda
Anna
A
Department of General and GI Surgery, Faculty of Medicine, Medical College, Jagiellonian University, Kraków, Poland.
Kuśnierz-Cabala
Beata
B
Nowak
Wojciech
W
Naskalski
Jerzy W
JW
Kulig
Jan
J
D000208:Acute Disease; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism*; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D002118:Calcium / Q000097:blood; D018450:Disease Progression; D005260:Female; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000378:metabolism; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*; D000685:Serum Amyloid A Protein / Q000378:metabolism*; D012720:Severity of Illness Index; D013997:Time Factors; D014057:Tomography, X-Ray Computed
D015415:Biomarkers; D001786:Blood Glucose; C000606589:CALCA protein, human; D011498:Protein Precursors; D000685:Serum Amyloid A Protein; D002116:Calcitonin; D002097:C-Reactive Protein; D007770:L-Lactate Dehydrogenase; D015740:Calcitonin Gene-Related Peptide; D002118:Calcium